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1、Page 1Chinese Help Lines Volunteer QuestionnairePLEASE SUBMIT THE QUESTIONNAIRE TOGETHER WITH THE APPLICATION FORM The purpose of this questionnaire is to determine your learning needs for upcoming volunteer training. As well, this questionnaire serves to orient staff to the new volunteer and orient
2、 the new volunteer to the requirements of the Help Lines. Please answer the following questions in the space provided. (When filling in the form, please enable your Microsoft Office active x)1.What are your reasons for working on the help lines?2.How is helping someone on the help lines different th
3、an helping a friend or family member?3.a. What does emotional support mean to you?b.How do you support someone in this way?Page 24.In your opinion, when helping someone in a personal crisis, are there any concerns you have about making personal decisions for that caller? Please explain.5.a. Please d
4、escribe a time in your life when you had to be empathic towards another person. b. What did you say to that person? 6.One of our goals on the Help Lines is to assist callers as they solve problems in their lives. How would you do this?7.a. If any, what types of personal or familial loss or crisis ha
5、ve you experienced in the last year and a half? b. How did you cope with the above loss or crisis, and what did you learn from it?Page 38.Have you or anyone close to you been suicidal? How did you cope with it? 9.Are there any medical conditions that may affect your work on the help lines?10. Scenar
6、io: A woman calls and is lethargic and depressed. She says she has no energy and no motivation to do anything. She says she doesnt have any friends to talk to or socialize with. What might she be feeling? 11. Scenario: You are talking to a man who has lost his wife six weeks ago. He is tense and abo
7、ut to cry. In your mind, what would be best for him?12. Scenario: A mother calls for support because her son was killed by a drunk driver four weeks ago. What might she be feeling?Page 413. Scenario: You have been talking to a mother for 45 minutes. You have shared an intimate and honest relationshi
8、p during the 45 minutes. She is under a lot of pressure and often breaks out in tears. Suddenly she tells you that sometimes she disciplines her children by hitting them with a coat hanger. She feels guilty because of the bruises and scares the hanger leaves. As a crisis line volunteer, you are unde
9、r the same obligations as any citizen of Canada. What are the issues and how must you handle it?14. Scenario: You have worked with a caller for 60 minutes and she still does not feel better. You have done everything you have been trained to do as a volunteer and the caller is indicating she is frust
10、rated and tired now. How would you handle this situation?15. Scenario: A young 19 year old woman calls because she just discovered she is pregnant. She is not sure who the father is and she is not sure if she should keep the baby. a.What might she be feeling?b.How would you handle the call?Page 5REL
11、ATED VOLUNTEER OR WORK EXPERIENCE 相關義工或工作經驗相關義工或工作經驗Position Title 職位Organization 機構Start Date End Date日期Position Title職位Organization 機構Start Date End Date日期Position Title職位Organization機構Start Date End Date日期Position Title職位Organization 機構Start Date End Date日期RELATED TRAINING EXPERIENCE 相關訓練經驗相關訓練經驗
12、Training 訓練Organization機構Start Date End Date 日期Training 訓練Organization 機構Start Date End Date日期Training訓練Organization 機構Start Date End Date日期Training訓練Organization 機構Start Date End Date日期Training訓練Organization 機構Start Date End Date日期REFERENCES (please list at least two references) 推薦人推薦人（請填寫至少兩位請填寫至少
13、兩位）Work or school related name: 工作或學校相關 名字：Organization and Title 機構及職位Telephone 電話Personal reference from your community name: 私人推薦名字：Organization and title or relation to you: 機構及職位，或是與你的關係：Telephone 電話Personal reference from your community name: 私人推薦 名字：Organization and title or relation to you:
14、機構及職位，或是與你的關係：Telephone 電話Page 6EMEERGENCY CONTACT 緊急連絡人緊急連絡人Name 名字:Relation to you 與你的關係：Telephone 電話PLEASE MARK YOUR SHIFT AVAILABILITY 請填寫你有空的時間請填寫你有空的時間MondayTuesdayWednesdayThursdayFridaySaturdaySunday1000am-200pm200pm-600pm600pm-1000pmAt different times, Chinese Help Lines Services is looking for volunteers to work specific shifts. Please indicate your commitment to a particular shift. 在不同的時間，中文熱線會需要義工的幫助，請填寫你有空的時間。Date of Application Received (For Office use)
